Published online by Cambridge University Press: 25 October 2016
Etiological models propose that a biological vulnerability to emotional reactivity plays an important role in the development of borderline personality disorder (BPD). However, the physiological and phenomenological components of emotional reactivity that predict the course of BPD symptoms in adolescence are poorly understood. This prospective study examines pupillary and affective responses to maternal feedback as predictors of BPD symptom development in adolescent girls over 18 months. Fifty-seven 16-year-old girls completed a laboratory task in which they heard recorded clips of their own mothers making critical or praising statements about them, as well as neutral statements that did not pertain to them. Changes in girls’ pupil dilation and subjective affect were assessed throughout the task. The results demonstrated that greater pupillary response to maternal criticism predicted increases in BPD symptoms over time. In addition, greater pupillary and positive affective responses to maternal praise were associated with higher BPD symptoms at age 16 and faster decreases in BPD symptoms over time, but only among girls who heard clips that were rated by independent observers as less praising. The results suggest that emotional reactivity can serve as either a risk or a protective factor depending on context, with differential effects of reactivity to criticism versus praise.
This research and the efforts of the authors were supported by grants from the National Institute of Mental Health (K01 MH086713, Principal Investigator [PI] S.D.S.; R01 MH101088, PI S.D.S.; R01 MH056630, PI R. Loeber; K01 MH101289, PI L.N.S.; K01 MH086811, PI N.P.J.; F32 MH102895, PI J.E.B.), the National Institute on Drug Abuse (R01 DA012237, PI T. Chung), and by funding from the Office of Juvenile Justice and Delinquency Prevention (2013-JF-FX-0058, PIs A. E. Hipwell and S.D.S.), the FISA Foundation (PI R. Loeber), and the Falk Fund (PI R. Loeber).